Kornimate/medical-research-clean huggingface dataset:
macintosh versus macgrath for laryngoscopy in covid 19 hypoxemic icu patients

Conditions: COVID-19 Acute Respiratory Distress Syndrome

Summary: in this comparative prospective study, we aim to compare the classic macintosh laryngoscope and the mac grath videolaryncoscope in icu covid 19 patients recruiting intubation and invasive mechanical ventilation. patients meeting inclusion criteria were randomized in 2 groups: macgrath and macintosh. we collected anthropometric and intubation data among all patients, and the 2 groups were compared regarding the time for intubation, the need of alternative techniques to intubate and the impact on the oxygenation by recording the lowest spo2.

in this comparative prospective study, we aim to compare the classic macintosh laryngoscope and the mac grath videolaryncoscope in icu covid 19 patients recruiting intubation and invasive mechanical ventilation. all hypoxemic covid19 patients requiring intubation were enrolled in this trial. all patients had a preoxygenation with non invasive ventilation with 100% oxygen. patients meeting inclusion criteria were randomized in 2 groups: macgrath and macintosh. we collected anthropometric and intubation data among all patients, and the 2 groups were compared regarding the time for intubation, the need of alternative techniques to intubate and the impact on the oxygenation by recording the lowest spo2.

Eligibility criteria:
inclusion criteria: * all covid 19 hypoxemic patients requiring tracheal intubation exclusion criteria: * hypoxemic cardiac arrest before intubation

Keywords: tracheal intubation mechanical ventilation
disrupting fear-based memory consolidation

Conditions: Post-Traumatic Stress Disorder

Summary: this project represents a unique collaborative opportunity to pursue the essential proof-of-principle demonstration that non-invasive interference of sensory cortical memory consolidation shortly after an emotional experience can attenuate the cued fear response and potentially reduce the risk of developing post-traumatic stress disorder (ptsd). if successful, the study results would anchor a potential advance in the treatment of patients after a traumatic event and seed future animal and clinical studies of emotional sensory cortical memory consolidation to reduce the prevalence and negative sequelae of ptsd.

this mechanistic study in humans will study an unexplored precision-based approach of non-invasive neuromodulation of sensory cortex with the aim to prevent ptsd by attenuating the sensory encoding of fear memory. the objective of this project is to explore the basic science and therapeutic potential of sensory-emotional reprogramming in humans, and translate this idea into a precise, individualized treatment to reduce the risk that negative emotional sensory experiences lead to ptsd. understanding sensory-emotional programming in humans could anchor a breakthrough in the treatment of patients after a traumatic event and seed future animal and clinical studies of emotional sensory cortical memory consolidation to reduce the prevalence and negative sequela of ptsd.

Eligibility criteria:
inclusion criteria: * ability to provide informed consent * willingness to participate in study * no history of musculoskeletal impairment or neurological disease * clinical diagnosis of ptsd for individuals in the ptsd group. exclusion criteria: * any participant outside the age range * participants that show signs of dementia (score \< 20 on the montreal cognitive assessment) * participants that have a history of major head trauma, a neurodegenerative disorder, or recent (\<6 months) substance abuse; * participants that had a recent history of central nervous system (cns) active drugs that may influence cortical excitability or learning; or * participants that report contraindications to tms or mri - if participating in the tms/mri experiments * current psychoactive medication usage * current symptoms of psychosis or bipolar disorder (as indicated by study staff through a clinical interview as part of that study). * the study will exclude adults unable to consent, individuals who are not yet adults, pregnant women and prisoners on scientific grounds and to minimize risk.

Keywords: fear transcranial magnetic stimulation memory
does venous pco2 increase by 20 mmhg or more during apnea challenge test?

Conditions: Brain Death

Summary: one required examination for declaration of death by neurological criteria is the apnea challenge test. the apnea challenge test evaluates the medulla brainstem respiratory center response to a rise in co2. the current guideline requires arterial sampling of co2 and therefore either arterial puncture or arterial catheter placement for the examination. arterial catheter is an invasive monitoring device and is not without complications. recent studies have demonstrated that there is a direct correlation between peripheral venous and arterial blood gas measures and that peripheral venous co2 measures may be used as alternatives to arterial co2 measure.the purpose of this study is to evaluate brainstem response during the apnea challenge test to a rise in venous co2 and correlate it with the rise in arterial measured co2. the objective of this study is to demonstrate a similar rise between the venous and arterial co2 during the apnea challenge test and eliminate the necessity of arterial blood sampling for the sole purpose of apnea challenge test in the future.


Eligibility criteria:
inclusion criteria: 1. age \> 37 weeks gestation up to any adult age 2. patients admitted to pediatric intensive care unit (picu), neonatal intensive care unit (nicu), medical intensive care unit (micu) and cardiothoracic intensive care unit (cticu) 3. patients with irreversible brain injury where the attending physician will be performing death by neurological criteria examination as per hospital policy 4. presence of arterial catheter or arterial blood sampling during apnea challenge test 5. presence of central venous catheter or easily drawing peripheral intravenous catheter exclusion criteria: 1. age less or equal to 37 weeks gestation 2. inability to perform apnea challenge test as determined by primary physician 3. family request for donation after cardiac death (dcd) or withdrawal of life sustaining therapy 4. bicarbonate infusion within 30 minutes of apnea challenge test

Keywords: brain death apnea challenge test
study of alirocumab (regn727/sar236553) in patients with primary hypercholesterolemia and moderate, high, or very high cardiovascular (cv) risk, who are intolerant to statins (odyssey alternative)

Conditions: Hypercholesterolemia

Summary: this is a randomized, double-blind, double-dummy, active-controlled, parallel-group, multi-national, multi-center study to compare alirocumab (regn727/sar236553) versus ezetimibe in participants with primary hypercholesterolemia and moderate, high, or very high cv risk, who are intolerant to statins. an atorvastatin arm is added to determine that the population selected in the study is a truly statin intolerant population by assessing skeletal muscle-related adverse events.


Eligibility criteria:
inclusion: 1. patients with primary hypercholesterolemia \[heterozygous familial hypercholesterolemia (hefh) or non-fh\] with moderate, high or very high cv risk and a history of statin intolerance 2. provide signed informed consent exclusion: 1. calculated serum ldl-c \<70 mg/dl (1.81 mmol/l) and very high cv risk at the screening visit 2. calculated serum ldl-c \<100 mg/dl (2.59 mmol/l) and high or moderate cv risk at the screening visit 3. a 10-year fatal cardiovascular disease risk score \<1% at the screening visit (the inclusion/ exclusion criteria provided above is not intended to contain all considerations relevant to a patient's potential participation in this clinical trial).
group motivational intervention in overweight/obese patients

Conditions: Overweight; Obesity

Summary: overall mortality, such as that caused by cardiovascular disease, increases as weight increases. in the framingham study, it was shown that obesity is a cardiovascular risk factor independent of other risk factors such as type 2 diabetes mellitus, dyslipidemia and smoking. objectives: 1. to determine whether a group motivational intervention is more effective than the standard intervention for treatment of overweight and obesity and most importantly to maintain the attained weight loss on a permanent basis. 2. to assess whether this intervention is more effective than reducing cardiovascular risk factors (lipid profile, apo b-100, apo a-1, fibrinogen, c-reactive protein, hypertension, diabetes mellitus) associated with overweight and obesity, and the overall cardiovascular risk in these patients. design: randomized, multicenter, interventional clinical trial in patients with overweight and obesity. randomized assignment of the intervention by basic health areas (bhas). two groups will be established in geographically separate areas, one of which will receive the group motivational intervention (intervention group) and the other will receive standard follow-up (control group). bhas located in the same building will be assigned the same group (control or intervention) to avoid potential contamination. hypertensive treatment or with a diagnosis of hypertension in their clinical history. study scope: primary care. the study will be conducted in 24 bhas of hospitalet de llobregat and barcelona during 26months follow-up period. haematic analyses will be in the carried out at the reference laboratory.


Eligibility criteria:
inclusion criteria: * overweight (bmi\>25) and obese (bmi\>30) patients of both sexes, registered in the medical history (mh) or newly diagnosed. * aged between 30 and 70 years * agreement to participate in the study exclusion criteria: * patients with severe clinical pathology (bedridden, dementia, advanced neoplasia, etc.) * patients with secondary obesity (hypothyroidism, cushing's disease, etc). * patients with severe sensorial disorders capable of interfering with the motivational intervention * patients with serious psychiatric disorders

Keywords: motivational intervention
comparison of a new masterful preparation to kligman's trio in the treatment of melasma

Conditions: Melanosis

Summary: kligman's trio remains the gold standard treatment for melasma. it contain hydroquinone which is an effective anti-melanogenic compound but that has poor tolerance and numerous side-effects. thiamidol has been proven to be at least as effective as hydroquinone and has a very good safety profile. the objective of this study is to compare the kligman's trio to the same preparation in which hydroquinone is replaced by thiamidol.


Eligibility criteria:
inclusion criteria: * signed written consent 1) melasma clinically diagnosed exclusion criteria: 1. pregnant woman 2. other pigmentary disorder affecting the face 3. use of systemic or topical steroids or retinoids, use of topical depigmenting agents or depigmenting procedure in the month before the inclusion
sipom vs pipom in incisional hernia patients

Conditions: Incisional Hernia

Summary: nowadays, two intraperitoneal mesh approaches are commonly used in laparoscopic ventral hernia repair (lvhr): the simple intraperitoneal onlay mesh repair (sipom) and the intraperitoneal onlay mesh reinforcement with defect closure before placement of mesh (pipom). the pipom has been introduced to reduce adverse events in incisional hernia (ih) surgery (i.e., seroma formation, recurrences etc ) associated to laparoscopic hernia repair, and satisfactory outcomes has been reported in several studies. in details, sequelae such mesh bulging seems to be less associated to pipom than sipom, even if the latter topic is matter of intense debate. the pipom has been introduced in the guidelines for the laparoscopic treatment of ventral and incisional abdominal wall hernias published by the international endohernia society (iehs) in 2014. despite prospective studies on the quality of ipom-plus are available, the evidence level for the statements in these guidelines remains low. the aim of this prospective analysis is to compare the postoperative outcomes of patients treated for incisional hernia (ih) with sipom and pipom after 36 months follow-up in terms of recurrence and wound events.


Eligibility criteria:
inclusion criteria: * incisional hernia whit length \>3 and \<12 in width or length (medium size according to european hernia society classification incisional hernias * body mass index (bmi) \< 35 kg/m2 * elective surgery setting * clean wound field according to the centre for disease control and prevention (cdc) wound classification (grade i) exclusion criteria: * incisional hernia \ 12 cm * abdominal aortic aneurysm disorders * pregnancy or lactation * psychiatric illness * multifocal hernia defect * life expectancy\<2 years * inflammatory bowel disease * emergency setting
photobiomodulation for patients with advanced heart failure

Conditions: Heart Failure With Reduced Ejection Fraction; Heart Failure, Systolic

Summary: the objective of the study is to examine the effectiveness of photobiomodulation therapy in patients with advanced-stage heart failure with reduced ejection fraction (hfref), who have been referred but ineligible for a heart transplantation. the primary endpoint is a 15% relative reduction in left ventricular end-systolic volume (lv esv) as determined by echocardiography over a 12-month follow-up period. the secondary objective is to determine the change in nt-probnp, a biomarker for heart failure, the change in heart failure symptoms based on the nyha functional classification, the change in quality of life questionnaire (kccq), additional echocardiographic parameters, and the detection of changes in heart failure and fibrosis biomarkers. additionally, the study aims to examine hospitalization due to heart failure and overall mortality.


Eligibility criteria:
inclusion criteria: advanced-stage hfref patients who were ineligible for heart transplantation patients over 18 years of age the expected lifespan exceeds 1 year consent form exclusion criteria: non-compliant patient pregnant women drug or alcohol abuse the patient is participating in another clinical trial
exercise training for rectal cancer patients

Conditions: Rectal Neoplasms

Summary: cancer treatments often cause acute toxicity during treatment, and late toxicity after treatments have ended. bowel dysfunctions, incontinence (anal and urinary) and dysfunction are late side effects associated with cancer treatment in general, and patients treated for pelvic malignancies are at a higher risk. in norway, the incidence of rectal cancer was 1329 in 2010. advances in the treatment during the past few decades have led to fewer local recurrences and increased long-term survival, and today the relative survival is 66% for women and 64% for men. more patients are having sphincter-preserving surgery with low colorectal or ultralow coloanal anastomoses, and low anterior resection (lar) is done in 70% of the patients with curative surgery. unfortunately, many patients experience altered bowel function after lar. frequent bowel movements, urgency, evacuatory difficulties and fecal incontinence are common and distressing complications. these functional disturbances are seen in up to 50-60% of the patients, and most frequent when surgery is combined with neoadjuvant therapy. urinary incontinence and decreased sexual function is also common in both men and women following rectal cancer treatment. in many surgical settings, patients with higher preoperative physical fitness rehabilitate more quickly and have fewer operative complications compared with patients who are less physically fit. additionally, specific strength training of the pelvic floor muscles builds up muscle volume, elevates the location of the pelvic floor muscles and pelvic organs, and closes the levator hiatus thus providing improved structural support for the pelvic floor as well as more optimal automatic function. the aim of the present trial is to investigate whether exercise training including pelvic floor muscle training during preoperative radiotherapy can reduce symptoms of bowel, urinary and sexual dysfunction and affect the physiology of the anal sphincter muscle after lar. in addition quality of life, cardiopulmonary parameters and postoperative complications will be studied.


Eligibility criteria:
inclusion criteria: * cancer recti * planned curative lar with preoperative radiotherapy * cancer stadium i-iii * able to speak and understand norwegian exclusion criteria: * previous radiotherapy * previous pelvic surgery * diseases affecting the anal sphincter

Keywords: exercise pelvic floor prehabilitation fecal incontinence urinary incontinence sexual dysfunction, physiological
a multi-national, prospective, observational study in patients with unresectable or metastatic melanoma

Conditions: Advanced Cutaneous Melanoma

Summary: the purpose of this study is to examine the safety of ipilimumab and patterns of use in the treatment of unresectable or metastatic melanoma in the post-approval setting

time perspective: this study does have a retrospective component involving a subset of patients

Eligibility criteria:
for more information regarding bms clinical trial participation, please visit www.bmsstudyconnect.com. inclusion criteria: * diagnosis of unresectable or metastatic melanoma * age of 18 years or older at time of entry into the study * patients who have initiated treatment for unresectable or metastatic melanoma at medical practice (e.g. community-based, office-based, hospital-based, academic setting)within 21 days before informed consent for this study or in the case where treatment has not yet been initiated, documentation that the treatment strategy was determined before informed consent for this study, and treatment must be initiated within 28 days after informed consent * ipilimumab-treated patients must be receiving treatment for the indication(s) approved in their country of residence or where they are receiving treatment exclusion criteria: * current or pending participation in a clinical trial examining therapy for the treatment of any cancer (including unresectable or metastatic melanoma) * current use of therapy to treat a primary cancer other than melanoma

Keywords: unresectable or metastatic cutaneous melanoma
influence of the method of alleviation of aorto-caval compression on the trans-hepatic ultrasound-assessed inferior vena cava diameter in pregnant patients

Conditions: Pregnancy; Cardiac Arrest

Summary: cardiac arrest during pregnancy is rare but may result in poor maternal and fetal outcome. because of its rare occurrence and ethical issues this topic is not very well studied and many questions pertaining to maternal resuscitation remain unanswered. one of the challenging aspects of cardiopulmonary resuscitation in a term pregnant patient is the ideal positioning during chest compressions. international societies have made recommendations regarding management of pregnant patients during cardiac arrest. they advocate the use of left lateral position with 30 degrees tilt or manual uterine displacement. however these recommendations are not based on high level of evidence. ultrasound has been used to visualize the change in diameter of great vessels to determine the volume status or adequacy of blood circulation of these patients. this approach can be used to study the adequacy of blood circulation of pregnant patients in different positions. the objective of this study is to compare the change in inferior vena cava diameter obtained with pregnant women in either the left lateral tilt or in the supine position with a manual uterine displacement, compared to the left lateral position and the supine position. our hypothesis is that the inferior vena cava diameter obtained in the supine position with manual left uterine displacement would be larger as compared to that obtained with women positioned with a 30-degree tilt.

using the non-invasive technology of ultrasound we will be able to determine the degree of aorto-caval compression in pregnant women placed in different positions. the results of this study will help us to determine the optimal patient positioning for each individual. this in future may help us in improving outcomes not only during labor and anesthesia, but also during maternal resuscitation in critical cases. the results of this study will help us to determine the best technique to minimize aorto-caval compression in the term pregnant patient. the results of this study will be useful to establish firm maternal resuscitation guidelines. we will be able to determine the optimal maternal position during cardiopulmonary resuscitation and this may improve both maternal and fetal resuscitation outcomes.

Eligibility criteria:
inclusion criteria: * asa i or ii * term pregnancy (36-40 weeks) * singleton pregnancy exclusion criteria: * patients with known cardiac disease, severe preeclampsia on medication * multiple gestation * breech presentation * patients unable to comply with the 4 positions (left lateral, left tilt, supine and supine with manual displacement) * patients unable or unwilling to consent

Keywords: cardiopulmonary resuscitation pregnancy ultrasound inferior vena cava
pre-emptive trans-cutaneous versus trans-oral ultrasound guided peritonsillar infiltration with bupivacaine during tonsillectomy

Conditions: Postoperative Pain Management

Summary: ultrasound as a technique is safe, readily available, quick and portable allowing more accuracy of different regional blocks and local infiltration. it allows imaging of the mouth, oropharynx, infrahyoid structures, larynx, vocal cords, and trachea. recently, ultrasound has been shown to improve accuracy in ultrasound guided block with local anesthetic infiltration. the objective of our study is to compare the effect of pre-emptive trans-oral ultrasound guided peritonsillar infiltration versus trans-cutaneous ultrasound (us) guided peritonsillar infiltration with bupivacaine for post-tonsillectomy analgesia, on surgical field, and surgeon satisfaction(intra-operative reactionary bleeding). materials and methods: the patients will be admitted for tonsillectomy at ent department of the al- azhar university hospitals. the patients' ages between 3 to 15 years. patients will be divided into cutaneous group: patients will be submitted to trans-cutaneous ultrasound guided peritonsillar infiltration with bupivacaine, and oral group: patients will be submitted to trans-oral ultrasound guided peritonsillar infiltration with bupivacaine.


Eligibility criteria:
inclusion criteria: * asa (american society of anesthesiologists) physical status i-ii with no airway complications or systemic diseases or known psychological diseases. reason for their surgery was recurrent or chronic tonsillitis. exclusion criteria: * infection at the site of injection, peritonsillar abscess or cellulites.